Article

MRSA (methicillin resistant Staphylococcus aureus) is endemic in many British hospitals, and enormous attempts at control have not stemmed its relentless progress. Epidemic strains EMRSA-15 and EMRSA-16 each affect over 100 hospitals1 and the struggle for containment causes disruption and consumes resources.23 This failure to control MRSA raises the question of whether current interventions serve any purpose.

MRSA may not need any control. There is no convincing evidence, despite a vast body of literature, that it causes greater morbidity than methicillin sensitive S aureus (MSSA), which is more prevalent. During 1983-6 one hospital in Essex found that the ratio of MRSA to MSSA among blood culture isolates was identical to that in all other specimens,4 indicating that methicillin resistance was unrelated to virulence. A London study in 1991 also found no increase in virulence.5 Other antibiotic resistant bacteria arouse far less interest. For example, methicillin resistant coagulase negative staphylococci are often resistant to many antimicrobial agents, are implicated …